Weight regain after bariatric surgery: Promoters and potential predictors

Abstract

Obesity is globally viewed as chronic relapsing disease. Bariatric surgery offers the most efficient and durable weight loss approach. However, weight regain after surgery is a distressing issue as obesity can revert. Surgical procedures were originally designed to reduce food intake and catalyze weight loss, provided that its role is marginalized in long-term weight maintenance. Consequently, it is essential to establish a scientifically standardized applicable definitions for weight regain, which necessitates enhanced comprehension of the clinical situation, as well as have realistic expectations concerning weight loss. Moreover, several factors are proposed to influence weight regain as psychological, behavioral factors, hormonal, metabolic, anatomical lapses, as well as genetic predisposition. Recently, there is a growing evidence of utilization of scoring system to anticipate excess body weight loss, along with characterizing certain biomarkers that identify subjects at risk of suboptimal weight loss after surgery. Furthermore, personalized counseling is warranted to help select bariatric procedure, reinforce self-monitoring skills, motivate patient, encourage mindful eating practices, to avoid recidivism.

Keywords: Weight regain; Bariatric surgery; Hormones; Diet; Exercise; Genetic factors

Core Tip: Obesity constitutes an enormous health struggle worldwide. Weight regain after bariatric surgery is a distressing issue that requires extensive study; various influencing factors as well as predicting biomarkers must be considered carefully before making decision for surgery, selecting bariatric procedure as well as close long term monitoring and support are essential.